游离中鼻甲黏膜瓣在神经内镜经鼻蝶低流量脑脊液鼻漏修补中的成功率及安全性分析

Success Rate and Safety Analysis of Free Medium Turbinate Mucosal Flap in the Repair of Neuroendoscopic Transnasal Sphenoplasty

目的 分析神经内镜经鼻蝶修补术中采用游离中鼻甲黏膜瓣的成功率及安全性。方法 非随机选取南京医科大学附属江宁医院于2020年12月—2022年12月收治的218例脑脊液鼻漏患者作为研究对象,根据不同治疗方法分为对照组、观察组,每组109例。两组患者均采取神经内镜经鼻蝶修补术,对照组予以带血管蒂鼻中隔黏膜瓣进行修补,观察组予以游离中鼻甲黏膜瓣进行修补。比较两组患者的手术成功情况、不良事件发生情况及生活质量。结果 观察组的总成功率高于对照组,差异有统计学意义(P<0.05);观察组不良事件总发生率(2.75%)低于对照组(9.17%),差异有统计学意义(χ^(2)=4.008,P<0.05)。观察组各项生活质量评分均高于对照组,差异有统计学意义(P均<0.05)。结论 对于低流量脑脊液鼻漏患者而言,在神经内镜经鼻蝶术中采取游离中鼻甲黏膜瓣修补的手术成功率更高,且能提高患者生活质量,术后不良事件较少。

Objective To analyze the success rate and safety of free middle turbinate mucosa flap repair in neuroendoscopic transnasal sphenoplasty.Methods A total of 218 patients with cerebrospinal fluid rhinorrhea admitted to Jiangning Hospital Affiliated to Nanjing Medical University from December 2020 to December 2022 were non-randomly selected as the study objects,and were divided into control group and observation group by different treatment modalities with 109 cases in each group.Neuroendoscopic transnasal sphenoplasty was performed in both groups.The control group was repaired with vascular pedicled nasal septum mucosa flap,and the observation group was repaired with free middle turbinate mucosa flap.The operation success,incidence of adverse events and quality of life of the two groups were compared.Results The total success rate of observation group was higher than that of control group,the difference was statistically significant(P<0.05).The total incidence of adverse events in the observation group(2.75%)was lower than that in the control group(9.17%),and the difference was statistically significant(χ^(2)=4.008,P<0.05).The quality of life scores of the observation group were higher than those of the control group,and the differences were statistically significant(all P<0.05).Conclusion For patients with low-flow cerebrospinal fluid rhinorrhea,the operation of free middle turbinate mucosal flap repair in neuroendoscopic transnasal sphenoplasty has a higher success rate,and can improve patients' quality of life with fewer postoperative adverse events.